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June 1960

Influence of Head Position upon Cerebral Circulation: Studies on Blood Flow in Cadavers

Author Affiliations

From the Department of Neurology, University of Pennsylvania School of Medicine and the Hospital of the University of Pennsylvania.
Currently at the National Hospital, Queen Square, London (Dr. Tucker).

AMA Arch Neurol. 1960;2(6):616-623. doi:10.1001/archneur.1960.03840120022003

Patients with clinical evidence of cerebral vascular insufficiency frequently relate that a particular head position may precipitate their symptoms. Usually, extension of the head, as in looking upward, or lateral rotation, as in looking over the shoulder, is mentioned. In a previous study1 we found that many such patients tolerated compression of a carotid artery when their heads were face forward but quickly developed signs and symptoms of insufficiency when carotid compression was repeated after the head had been turned to one side. In the past, those2,3 who have recognized this influence which head position can have upon response to carotid compression have usually attributed it to stimulation of a carotid sinus reflex mechanism or to local anatomical factors which permit more effective compression of the sinus when the head is rotated. In this paper we suggest that a more important factor may be change in blood flow

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